Professional Format Billing January 2019

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Overview

• Professional Format Billing • Electronic Claim Submission

– Practice Management Software – Health Enterprise – PayerPath – Attachments

• Paper Claim Form • Medicare/Medicaid crossover • Tips for Success

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Professional Format Billing

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National Uniform Claim Committee (NUCC)

• NUCC is the organization that created and maintains the CMS-1500 • Named as one of six Designated Standards Maintenance Organizations • Maintain electronic claims standards • Maintain CMS-1500 paper claim standards • http://www.nucc.org

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Claims Submission Methods

There are several billing options for Alaska Medical Assistance providers. • 837P Transaction (electronic claim using billing software)

– Companion Guide: http://medicaidalaska.com – Implementation Guide (referred to as TR3): http://www.wpc-edi.com

• Alaska Medicaid Health Enterprise • Payerpath (electronic claim)

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Professional Format Billing Providers

• ANP/Nurse Midwife • Audiologist • Behavioral Health: Community Behavioral Health & Mental Health Physician Clinic • Care Coordination/Care Coordination Agency • Certified Registered Nurse Anesthetist • Chiropractor • Community Health Aide/Practitioner • Dietician • Direct Entry Midwife • Durable Medical Equipment/Respiratory Therapy • EPSDT • Environmental Modifications

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Professional Format Billing Providers (cont.)

• Family Planning Clinic • FQHC/RHC • Health Professional Group • Home and Community Based Agency • Home Infusion Therapy • Independent Laboratory Services • IHS & Tribal Services/Tribal Clinic • Nutrition • PCA/Agency • Physician • Physician Assistant • Podiatry

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Professional Format Billing Providers (cont.)

• Private Duty Nurse • Prosthetic & Orthotic Supplier • Psychologist • Radiology Services • Residential Supported Living • School-Based Services • Targeted Case Management • Therapies: Occupational, Physician, Speech-Language • Vision

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Electronic Claim Submission

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Electronic Billing Options

There are several options available for providers who want to bill electronically: • Practice management/billing software • Health Enterprise • PayerPath

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Practice Management Software

• HIPAA mandated 837 format (X12N/005010X222A1) • Use existing practice management software to export files in a HIPAA

compliant format and submit the files to Conduent electronically • Your software vendor will know if your software can export an electronic file • Other transaction types are available as well as 837

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Electronic Claim Submission Requirements

• Provider or Billing Agent Information Submission Agreement • Successful testing of electronic claim submission

– Provide valid/real data in test files – Recommend at least 25 – 50 transactions but not more than 200

• Billing Agent should review the negative acknowledgement • Once testing is successful, you will be notified that you can begin to submit

production transactions

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Electronic Billing Resources

• Contact Conduent Electronic Commerce Customer Support (ECCS) coordinator at 907.644.6800 option 3 or 800.770.5650 option 1, 4

• Alaska Medicaid Specific Companion Guide – http://medicaidalaska.com Documentation> Documents & Forms>Companion Guides,

select Alaska Enterprise 5010 837P Companion Guide v1.07 • Implementation Guide

– http://www.wpc-edi.com

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Health Enterprise

• Providers can also bill through Health Enterprise • Must be enrolled with AK Medicaid and have an account on the portal • Accessed through www.medicaidalaska.com • Detailed CBTs available on the Learning Portal at

http://manuals.medicaidalaska.com/docs/akmedicaidtraining.htm select Providers> Enterprise>Enterprise Service Areas to see the full array of automated trainings available

Create New Claim

• Starting on your Home page, hover over Claims, then over Create Claims and choose Create Professional Claim

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Form View vs. 837 View

• There are 2 different views of the Health Enterprise claim form screens

• Form view is formatted to look like the CMS-1500 claim form and shows all fields in one continuous screen

• 837 view has the same fields but is formatted somewhat differently and organized in tab sections

• Providers may toggle between the views as needed

• The Switch View link in the upper right corner of the screen allows providers to change between the views

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Void or Replacement Claim

• If this is a void or replacement claim indicate Yes • Select the Resubmission Type Code from the drop down box either Replacement or Void • Enter the TCN you are replacing or voiding • This is only applicable for claims that were submitted through Health Enterprise • Selecting No moves you forward in creating your new claim

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Patient Information

• Enter member-specific information • Required fields are noted with an * • Fields with a drop down box with options to choose from are represented with

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Third Party Liability

• Indicate if the member has another Health Benefit Plan • If Yes, complete the fields to provide all relevant information

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Condition Information

• If the member condition is related to an accident enter the applicable code

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Claim Detail

• Enter the appropriate diagnosis code(s) • Enter the service details as required by the * and click save (save must be

completed after each line entry) • Enter Rendering Provider NPI (other fields are optional)

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Additional Claim Information

• Enter additional claim information as required by * • Enter the member account number as assigned by the organization • Enter total claim amount • Enter the place of service • Enter primary payment information if applicable • Indicate assignments • Indicate provider signature is on file

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Attachments

• If the claim has attachments indicate Yes • Click on the Add Attachment button, the screen will refresh • Indicate the attachment type from the option in the drop down box

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Attachments (cont.)

• Indicate manner that attachments will be submitted and save • System will generate Attachment Control # - document this number on the

attachments you submit • Remember to click Save in this section

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Service Facility Location Information

• Enter all relevant information about the location where the services were rendered

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Billing Provider Information

• Enter information about the billing provider in these fields • The buttons for saving and submitting the claims are shown at the bottom of the screen

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Pay-To Address

• This field defaults to Yes as per enrollment. • If the answer to this question is No, an update will need to be made to the enrollment file.

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PayerPath

• Providers may bill electronically using PayerPath • Claims are submitted via the internet

– Free internet-based claims submission system – Immediate claims editing – Correction prior to submission – Patient re-bill demographics – Export files from practice management systems to PayerPath, eliminating

the need for “double entry” • PayerPath is not available for all provider types

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Attachments

• When billing using paper claim forms, attachments should be sent in along with the claim

• When billing electronically, attachments must be faxed in the same day you transmit the claim

• For electronic billing, an attachment control number must be: – Entered into the electronic claim – Written on the attachment(s) – Documented on the fax attachment cover sheet – Enterprise automates some of this process for you for claims submitted through

the portal

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Electronic Transaction Attachments

837 Professional claim supplemental information: • Loop 2300 – claim information • Paperwork (PWK) Segment – claim supplemental information • Element PWK06 allows you to create a unique number/identifier for the

attachment • The number/identifier should be different for every transaction sent

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Electronic Transaction Attachments (cont.)

PWK segment supplemental claim information • PWK 01 Report Type codes • PWK 02 Report Transmission Code

– FX - fax is the only acceptable mode • PWK 05 Identification Code Qualifier

– AC - Attachment Control Number • PWK 06 Identification Code

– Attachment Control Number generated by provider/submitter

Attachment Fax Cover Sheet

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Paper Claim Form

Paper Claim Form Font and Alignment • A large percentage of paper claims are processed through a scanner that extracts the information from the claim.

It is very important that providers ensure printed paper claim forms are legible and correctly aligned to prevent processing errors. Also, do not use red ink because the scanner is designed to overlook anything in red.

• Use a font that clearly distinguishes between all characters, such as “O” vs “0”, “I” vs “1”, and “2” vs “Z”

Can you immediately tell the difference between “O” and “0” or “2” and “Z”?

• The scanner can interpret information only if it directly resides within each field. If the alignment is off, data may be lost or misinterpreted.

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O24429 Z370

What was submitted

What the scanner reads

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CMS 1500

The Alaska Medicaid CMS-1500 Claim Form Instructions can be reviewed on http://manuals.medicaidalaska.com/docs/ProviderReference.html

Fields 1 - 6

• Field 1, (M), Medicare/Medicaid/TRICARE/etc. ‒ Select Medicaid ‒ For Medicare crossover claims, select both Medicaid and Medicare

• Field 1a, (M), Insured’s ID Number ‒ Enter the member’s 10-digit Alaska Medical Assistance identification number

• Field 2, (M), Patient’s Name ‒ Enter the Medicaid recipient’ name as it appears on the eligibility card or coupon

• Field 3, (O), Patient’s Birth Date, Sex • Field 4, (O), Insured’s Name

‒ Medicaid recipient is always the insured • Field 5, (O), Patient’s Address • Field 6, (M), Patient’s Relationship to Insured

‒ Select Self

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M = Mandatory C = Conditional O = Optional B = Leave Blank

Fields 7 - 9

• Field 7, (O), Insured’s Address • Field 8, (B), Reserved for NUCC Use • Field 9, (C), Other Insured’s Name

‒ Complete if the recipient has other insurance, except if an approved TPL avoidance record applies to services billed, leave blank

• Field 9a, (C), Other Insured’s Policy or Group Name ‒ Complete if the recipient has other insurance, except if an approved TPL avoidance record

applies to services billed, leave blank • Field 9b, (B), Reserved for NUCC Use • Field 9c, (B), Reserved for NUCC Use • Field 9d, (C), Insurance Plan Name or Program Name

‒ Complete if the recipient has other insurance, except if an approved TPL avoidance record applies to services billed, leave blank

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M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 10 – 11a • Field 10a, (M), Is Patient’s Condition Related to Employment? • Field 10b, (M), Is Patient’s Condition Related to Auto Accident? • Field 10c, (M), Is Patient’s Condition Related to Other Accident? • Field 10d, (C), Claim Codes (Designated by NUCC)

– An attachment is required for each reported code – Refer to the provider billing manual for details on attachment requirements for abortion and

sterilization services • Field 11, (C), Insured’s Policy, Group, or FECA Number

– For Medicare crossover claims, enter Medicare, even if another TPL exists • Field 11a, (C), Insured’s Date of Birth, Sex

– Use to report TPL-related insured’s information, only

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 11b - 14

• Field 11b, (C), Other Claim ID (Designated by NUCC) – Use to report TPL-related information, only

• Field 11c, (B), Insurance Plan Name or Program Name • Field 11d, (M), Is There Another Health Benefit Plan?

– Choose yes to report health plans other than Medicaid • Field 12, (M), Patient’s or Authorized Person’s Signature • Field 13, (M), Insured’s or Authorized Person’s Signature • Field 14, (O), Date of Current Illness, Injury, or Pregnancy (LMP)

– If date is reported, applicable qualifier is required

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 15 - 17 • Field 15, (O), Other Date • Field 16, (O), Dates Patient Unable to Work in Current Occupation • Field 17, (C), Name of Referring Provider or Other Source

– Referring, ordering, and prescribing providers must be enrolled with AK Medical Assistance

– If member is enrolled in the Care Management Program and rendering provider is not the primary care provider (PCP), a copy of the PCP’s referral must be attached to the claim

• Field 17a, (C), Other ID # – Required if a provider is entered in field 17

• Field 17b, (C), NPI # – Required if a provider is entered in field 17

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 18 - 21

• Field 18, (B), Hospitalization Dates Related to Current Services • Field 19, (O), Additional Claim Information (Designated by NUCC) • Field 20, (B), Outside Lab? $ Charges • Field 21, (M), Diagnosis or Nature of Illness or Injury

– Enter 0 as the ICD indicator – Enter the appropriate ICD-10 diagnosis code or codes – Atypical providers may use the codes on the next two slides, though if

they have a code that more accurately describes the member’s medical condition and justification for services, they should use that code in place of the suggested codes

– The diagnosis pointer in field 24e refers back to this field

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Atypical Provider Suggested Codes

Provider Type ICD-10 Codes Adult Day Service Z74.3 Care Coordination Z02.9 Chore Z74.2 Congregate Meals Z74.8 Day Habilitation Z60.4 Environmental Modifications Z59.1 Home Delivered Meals Z74.2 Hotel/Motel Z75.3 Intensive Active Treatment Z73.9 Lifeline Waiver V75.4

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Atypical Provider Suggested Codes

Provider Type ICD-10 Codes Personal Care Agency Z74.1 Pre-Employment (Individual/Group) Z73.6 Pre-Maternal Z75.8 Residential Habilitation Z73.6 Residential Supported Living Arrangements Z74.8 Respite Z74.2 or Z75.7 Supported Employment (Individual/Group) Z73.6 Taxi Services Z75.3 Transportation Z73.6

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Fields 22 - 24

• Field 22, (B), Resubmission and/or Original Reference Number • Field 23, (C), Prior Authorization Number

– If service billed requires authorization, enter the alpha-numeric prior (service) authorization ID

• Section 24 – Section 24 is used for entering information about billed services – In the shaded area of section 24, enter supplemental information to

support the billed service

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 24a – 24g • Field 24a, (M), Dates(s) of Service

– Submit single dates of service only; spanned dates will be denied • Field 24b, (M), Place of Service • Field 24c, (C), EMG

– Note: Emergency services are not subject to cost sharing – Refer to provider billing manuals for definition of emergency

• Field 24d, (M), Procedures, Services, or Supplies • Field 24e, (M), Diagnosis Pointer • Field 24f, (M), $Charges • Field 24g, (M), Days or Units

– If member is a resident of a long-term-care facility, enter LTC in the shaded area – For J Codes, use the NCPDP billing unit standard for the medication; correct billing

units are available at http://www.ncpdp.org/Standards-Development/Billing-Unit-Requests

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 24h – 24j

• Field 24h, (C), EPSDT/Family Plan – AK Medicaid requires reporting for EPSDT related services – Use the appropriate reason code found in the NUCC manual to represent the EPSDT-related service – Enter Y in the unshaded if the service you are billing for is family planning

• Field 24i, (C), ID Qualifier – Typical providers – AK Medicaid strongly recommends using the rendering provider taxonomy and qualifier

ZZ – Atypical providers – enter G2

• Field 24j, (C), Rendering Provider ID # – Refer to your AK Medicaid provider billing manual to determine if you are required to identify the rendering

provider on your claims – Typical provider – in the shaded area, enter rendering provider’s taxonomy/AK Medicaid Contract ID – Atypical providers – enter 7-digit provider ID number

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Field 24 Shaded Area

Use the shaded area for supplemental information to support the billed service • NDC information to support the J codes • Narrative description of unspecified codes • Contract rates • Universal Product Numbers for reporting medical and surgical supplies • Anesthesia duration

Supplemental Information

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Billing for Drugs

• The Deficit Reduction Act of 2005 (DRA) included specific data submission requirements necessary to collect Medicaid drug rebates from drug manufacturers for physician-administered drugs. Additionally, Social Security Act Section 1927 requires state drug rebate participation. State Medicaid programs must gather and submit drug utilization information in order to secure drug rebates and receive Federal Financial Participation (FFP) for these drugs.

• For more information on the Medicaid Drug Rebate program, visit https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/index.html

• Alaska Medicaid outpatient drug coverage regulations can be found at 7 AAC 120.110 Covered Outpatient Drugs and Home Infusion Therapy

• Alaska Medicaid drug payment regulations can be found at 7 AAC 145.400 – 7 AAC 145.410

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Drug Rebate Applicability Drug rebates are applicable to: • Claims for medications administered in physician’s offices, clinics, and other outpatient settings, including

Medicare part B and C crossover claims • National Drug Code (NDC) information used in conjunction with appropriate HCPCS/CPT codes for

rendered services – NDC codes should be used with “A”, “C”, “J”, "P", “Q”, and "S" codes – Though not all-inclusive, providers may refer to the NDC/HCPCS Crosswalk at

https://www.dmepdac.com/palmetto/PDAC.nsf/DID/B723CU33 to determine the appropriate HCPCS code for the NDC being used

Drug rebates are not applicable to: • IHS and tribally operated 638 facilities reimbursed at the federally published all-inclusive rate • ESRD bundled claims unless modifier "AY" is used to indicate an item or service rendered to an ESRD

patient is not for treatment of ESRD

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Identifying Drugs on Claims

To correctly identify the drugs and manufacturers to invoice and collect rebates, the Centers for Medicare and Medicaid Services (CMS) deemed that the use of NDC numbers is critical because there often several NDCs linked to a single HCPCS code. • Alaska Medicaid will pay claims submitted for these drugs only if the manufacturer participates in the Federal Drug

Rebate program and federal matching funds are available – Quarterly Drug Rebate listings are available on the CMS website

https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/data/index.html • Bill the National Drug Code (NDC) for the actual drug that is administered • Record the NDC into the patient record • Do not use a miscellaneous code if a specific HCPCS-NDC match is available

National Drug Codes

• The NDC is found on the prescription drug label of the drug container (e.g. vial, bottle or tube). The NDC is a universal number that identifies a drug or a related drug item

• NDC consists of 11 digits in three sections.

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National Drug Codes (cont.)

Examples: • Product label indicates: 54225-1798-29 • Submit on claim as: 54225179829

• Product label indicates: 452-72-89 • Submit on claim as: 00452007289

• Product label indicates: 45-6-9

– How would you submit this on a claim? – The correct answer is 00045000609

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NDC Information

Acceptable units of measure for recording NDC quantities are as follows: Milligram (mg) is not an acceptable unit

qualifier when billing NDC quantities.

Drugs administered using a mg dosage must be converted for billing to UN if in solid/powder form or ML if in a liquid/solution form. Only use the GR if the drug meets the description for the grams unit type.

Refer to the CMS Drug Products in the Medicaid Drug Rebate Program database for assistance in determining the correct “Unit Type required for billing.

https://data.medicaid.gov/Drug-Pricing-and-Payment/Drug-Products-in-the-Medicaid-Drug-Rebate-Program/v48d-4e3e/data

Code Unit Type Description

UN Unit Powder for injection (needs to be reconstituted), pellet, kit, patch, tablet, device

ML Milliliter Liquid, solution, or suspension

F2 International Unit

Products described as IU/vial or micrograms

GR Gram Ointments, creams, inhalers, or bulk powder in a jar

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Converting NDC Units to HCPCS Units

• Providers are required to submit the NDC unit of measure and units administered as well as the HCPCS equivalent units on the claim form – The requirement is the same for Medicaid and Medicare crossover claims – Providers must identify the NDC, unit of measure, amount administered, the NDC strength, HCPCS code

and the HCPCS unit of measure

• Billing Note: NDCs must be billed with the corresponding HCPCS based on the description and quantity administered. Claims may be denied if a misc. HCPCS code is billed when an appropriate NDC to HCPCS match exists.

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Example • The NDC unit of measure for 60793070010 is mL and 1 mL was administered. The NDC strength equals

600,000 iU per mL. The corresponding HCPCS code, J0561, is measured at 100,000 iU per billed unit. • In this example, 1mL of this NDC equals 6 units of J0561.

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Example (cont.)

The following information would be reported on the claim form for this NDC

Billing Note

Decimals must be used on all Medicaid and Medicare claims when billing a fraction of an NDC unit.

Partial units billed without a decimal may be denied for excessive units

Description Example Value N4 qualifier N4

11 digit NDC number from the drug label 60793070010

NDC unit of measure mL

NDC units administered (Note: insert a decimal when reporting a fraction of a unit up to 3 decimal places.) 1 or 1.000

Corresponding HCPCS codes J0561

HCPCS units 6

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Fields 25 - 29

• Field 25, (O), Federal Tax ID Number • Field 26, (O) Patient’s Account No.

– If used, this provider-assigned account number will appear on the remittance advice • Field 27, (M*), Accept Assignment?

– Required of all providers except the following, which should leave the field blank: • Environmental Modification • Home and Community-Based Agency • Personal Care Agency

• Field 28, (M), Total Charge • Field 29, (C), Amount Paid

– If claim was billed to other insurance (including Medicare), attach explanation of benefits (EOB) indicated paid amount

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Fields 30- 32

• Field 30, (B), Reserved for NUCC Use • Field 31, (M), Signature of Physician or Supplier Including Degrees or Credentials • Field 32, (M), Service Facility Location Information

– A five digit zip code is required along with facility address; zip +4 is strongly recommended to improve claim processing

• Field 32a, (O) NPI# [Service Facility] – If used, record NPI for the service location

• Field 32b, (O), Other ID# [Service Facility] – If used, record the other ID for the service location

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Field 33

• Field 33, (M), Billing Provider’s Info & Phone # – Submitted information should match demographics on the Medicaid Provider

Agreement • Field 33a, (M*),NPI# [Billing Provider]

– This field is mandatory, *except for atypical providers, who should leave it blank • Field 33b, (C), Other ID# [Billing Provider]

– This field is conditional but recommended to improve claims processing • Typical providers, if submitted enter qualifier ZZ and billing provider’s taxonomy • Atypical providers must enter the G2 qualifier and billing provider’s Medicaid ID#

M = Mandatory C = Conditional O = Optional B = Leave Blank

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Medicare Crossover

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Medicare Crossover Claims

• Claims for members who have both Medicare and Medicaid that are being submitted electronically should automatically cross over from Medicare’s system to Medicaid’s

• If crossover claims do not appear on the Remittance Advice from Alaska Medical Assistance within one month of your receiving the EOMB from Medicare, contact Provider Inquiry at 907.644.6800, option 1, or 800.770.5650,Toll-free option 1; 1

• Only one service per claim document is permitted • Attach the Explanation of Medicare Benefits (EOMB) and EOB from third-party payer, if applicable, to each

crossover claim • If you are billing for Medicare/Medicaid dual eligible members using a paper claim form, document Medicare

billing appropriately on your claim form and include the EOMB with your claim

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Additional Resources

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Recordkeeping

• Recordkeeping requirements are documented in the Individual Provider Agreement and Tax Certification and Group Provider Agreement and Tax Certification

• Although most recordkeeping requirements are consistent for all providers, some requirements are provider-type specific

• Providers must maintain complete and accurate clinical, financial, and other relevant records to support the care and services for which they bill Alaska Medical Assistance for a minimum of 7 years from the date of service

• Providers are subject to audits, reviews and investigations

Providers must ensure their staff, billing agents, and any other entities responsible for any aspect of records maintenance meet the same requirements.

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Overpayments & Repayment of Payment Errors Providers should closely review each remittance advice (RA) to ensure it reflects accurate payment for all billed services, including correct member details and services provided. • In accordance with 7 AAC 105.220(e), Alaska Medical Assistance providers have 30 days

from the time of payment to notify the department in writing of a payment error. • Federal law (42 U.S.C. 1320(d)) requires repayment of overpayments to the department

within 60 days of identifying the overpayment. • Mail the written overpayment notification and a copy of the RA page detailing the overpayment

to the address below:

Conduent State Healthcare, LLC P.O. Box 240807 Anchorage, Alaska 99524-0807

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Provider Training

General Information

Want to learn more Alaska Medicaid? Providers can attend or access training on a wide variety of topics. Here are some of the resources available to you:

• Compliance and Ethics: Alaska Medicaid 101

• Introduction to Alaska Medicaid • Member Eligibility • Guidelines for Record Keeping • Provider Enrollment

Billing Help

• Institutional-Format Claims Billing • Service Authorizations • Adjustments & Voids • Electronic Transactions • Claims Management

Health Enterprise

• Introduction to Health Enterprise • Managing Online Claims • Online Claims Submission Overview • Managing Web Access & Passwords • AVRS Overview

View the available training options on our Learning Portal at http://manuals.medicaidalaska.com/docs/akmedicaidtraining.htm Or contact us at DL-AK-Learn@conduent.com for more information

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Additional Resources

Alaska Medicaid Health Enterprise website at http://medicaidalaska.com. • Information necessary for successful billing • Includes provider-specific Medicaid billing manuals and fee schedules You may also call: • Provider Inquiry

– Eligibility only – 907.644.6800, option 1,2 or 800.770.5650 (toll-free), option 1,1,2 – Claim status and other inquiries – 907.644.6800, option 1,1 or 800.770.5650 (toll-free), option 1,1,1

• EDI Coordinator – Electronic transaction assistance – 907.644.6800, option 3 or 800.770.5650 (toll-free), option 1,4

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Disclaimer

The information contained in this presentation was current at the time it was written. It was prepared as a tool to assist providers and is not intended to be all inclusive, grant rights, impose obligations, or function as a stand-alone document. Although every reasonable effort has been made to assure the accuracy of the information within the presentation, the ultimate responsibility for understanding Medicaid program regulations lies with the provider of services. The State of Alaska – Department of Health and Social Services – and Conduent, Incorporated employees and staff make no representation, warranty or guarantee that this compilation of information is error-free and/or comprehensive and will bear no responsibility or liability for the results or consequences of the use of this guide.

© 2016 Conduent Business Services, LLC. All rights reserved. Conduent™ and Conduent Design™ are trademarks of Conduent Business Services, LLC in the United States and/or other countries.